Johns Hopkins Health Alert
Prostatitis:Nailing Down the Diagnosis
According to one study, men with prostatitis have a quality of life so diminished that it is comparable to that of men who have recently suffered a heart attack. If you experience symptoms of prostatitis, the first step is getting a correct diagnosis. Johns Hopkins provides advice.
Prostatitis is a broad term for an infection or inflammation of the prostate. Over the past decade, urologists have identified four types of prostatitis:
- Acute bacterial prostatitis is a sudden-onset infection that lasts for several days.
- Chronic bacterial prostatitis is a recurrent infection that can last for weeks, subside, and then flare-up again.
- Chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CPPS) is diagnosed when no infectious organism can be identified.
- Asymptomatic inflammatory prostatitis is diagnosed when white blood cells are found in the prostatic secretions or prostate tissue of a man who has no symptoms of prostatitis.
A thorough diagnostic work-up for prostatitis is critical for several reasons. Some symptoms of prostatitis overlap with those of urethritis (inflammation of the urethra), cystitis (inflammation of the bladder), benign prostatic hyperplasia and prostate cancer, and these conditions must be ruled out. It’s also essential to distinguish between the various types of prostatitis because treatment that is effective for one type may have no effect on another.
Recognizing and accurately reporting your prostatitis symptoms is the first step in obtaining a correct diagnosis. After taking a detailed history of your symptoms, your urologist will conduct a number of diagnostic tests to rule out other conditions and to identify the type of prostatitis you have. Common tests include:
- Digital rectal exam (DRE). A digital rectal exam will tell your physician whether the prostate is swollen, tender, warm, and firm (suggesting an acute bacterial infection) or enlarged and either soft or firm (suggesting a chronic bacterial infection).
- Urine analysis. Your urine will be analyzed for the presence of bacteria. If chronic prostatitis is suspected, another urine sample may be collected after prostate massage.
- Prostate secretion analysis. A sample of prostate fluid obtained with prostate massage will be examined for signs of infection or inflammation.
- Prostate-specific antigen (PSA) test. An elevated PSA level can indicate an inflamed prostate or prostate cancer.
Posted in Enlarged Prostate on November 4, 2008
Reviewed June 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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About a month ago my father, 70 years old, had a colonoscopy. The anesthesiologist used Propifal to put him to sleep. A few days after the procedure he experienced pain in his lower abdomen and had to go to the emergency room. The ER doctor stated that his bladder was not working properly and that his prostate was enlarged. There were no indications that the colonscopy caused any internal damage. Of course, at age 70 you would expect some enlargement, but this enlargement was abnormal. He was given something to help with the urine flow and a catitor was inserted into the bladder. He told to see a Urologist in 4 days. The Urologist examined him and said his bladder was not working properly and his prostate was enlarged. My father was given a self-catator and told to come back in two weeks. The Urologist felt that the prostate would shrink and his bladder should return to normal. A few days later things started to improve, the bladder appeared to be working fine and the prostated started to shrink. However, the original symptoms returned, pain in the lower abdomen and difficulty urinating. He went back to the Urologist and now he's suggesting surgery to remove the prostate. Has anyone heard of these types of complications after a colonoscopy?
Posted by: SDaniel | September 26, 2009 6:00 AM
In response to SDaniel's question about possible prostate/urinary complications after a colonoscopy, while I am not a doctor, I am a patient of same age as your father, was going through a diagnostics process for prostate problems at the same time as having a colonoscopy. I happened to come upon your question with prior context when doing some more homework for a blog ( http://prostatecancerthejourney.posterous.com ) to share my experience starting with prostate problems. I suspect you were not able to share your father's entire story. For example, what is is PSA, on the assumption that he had a recent PSA test? What is the history of his PSA readings over the last few years. Has he had any previous symptoms. There are a lot of unanswered before anyone can really answer your question conclusively. I would suspect that unless the doctor who conducted the colonoscopy botched the procedure, it may be purely ocincidental that your father developed some inflammation of the prostate at the same time. From my own experience, I had prostatitis and my PSA velocity indicated perhaps more serious problems. A biopsy revealed cancer and I had my prostate removed two weeks ago. Make sure your father steps his way through a systematic decision making process before jumping to conclusions. If you would like to discuss more, please feel free to email me with a phone number and I will be glad to discuss my experience further. By the way, I live in Colorado and I went to New York City for surgery by perhaps the best specialist in the country. See http://www.roboticoncology.com/da-vinci-robotic-prostatectomy/ . Good luck, PeterW.
Posted by: peterw | November 5, 2009 3:10 PM
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Be aware that if you have been diagnosed and are treated for prostatitis, your PSA may remain elevated for some time, and use of the PSA to screen for prostate cancer may be confounded, possibly leading to unnecesssary biopsies.
Posted by: LymphActivist | November 9, 2008 9:17 PM